The findings also show that the following practices persist: use of intravenous rehydration; encouraging pushing during the expulsion stage; routine episiotomy; the Kristeller maneuver; use of early amniotomy
; and use of oxytocin to induce labor.
When combined with amniotomy
, it provides good clinical effectiveness and patient satisfaction4.
Prior to amniotomy
, 10 mL of amniotic fluid was aspirated with a sterile injector, followed by delivery of the neonate.
neither shortens spontaneous labor nor improves any of the following outcomes: length of first stage of labor, cesarean section rate, maternal satisfaction with childbirth, or Apgar score <7 at 5 minutes (strength of recommendation [SOR]: A, large meta-analyses of randomized controlled trials [RCTs] and a single RCT with conflicting results).
To accomplish this, many methods have been adopted including augmentation of labour by intravenous oxytocin and/ or by early amniotomy
. Many people use various antispasmodic agents like drotaverine, hyoscine, dicyclomine and valethamate bromide to accelerate the first stage of labour, thereby reducing the sufferings of labouring mother.
Artificial oxytocin was administered to four of the interviewees, amniotomy
and episiotomy were mentioned by three and the Kristeller maneuver (uterine fundal pressure) by one of the interviewees.
They then proceeded to have synchronous fore-water amniotomy
and incremental intravenous oxytocin titration.
Alternatively, if appropriate, cervical ripening followed by oxytocin IOL and amniotomy
will help the patient with a prolonged latent phase to enter the active phase of labor.
The argument might be that misoprostol still works whether the cervix is ripe or not but cervical assessment selects out candidates for immediate amniotomy
with or without oxytocin might be more expensive and more laborious than using misoprostol alone.
Labour induction with unfavorable cervix is done with prostaglandins, cervical Foleys catheter, mesoprostol then followed by amniotomy
and augmentation with oxytocin, when cervix is favorable then induction with amniotomy
and augmentation with oxytocin is carried out.
Most common methods of induction are amniotomy
, mechanical dilatation with a balloon catheter, pharmacological inductions with prostaglandin E1 (misoprostol), prostaglandin E2 (dinoproston), or oxytocin.
In contrast, when performing procedures where exposure to body fluids is anticipated, such as an amniotomy
or placement of an intrauterine pressure catheter, protection of mucous membranes, skin, and clothing are recommended, with a mask and eye protection, in addition to gloves and an impermeable gown.